（附脾胃积聚）
论一切气证 皆由忧戚中或盛怒中，动伤真气，致阴阳不和，结气于胸膈之间，壅滞不
快，饮食不下，遂成膈噎之疾，可与匀气散、五膈宽中散、膈气散、沉香降气汤、分气紫苏
饮、七气汤、嘉禾散、丁香煮散、分心气饮、小降气汤之类。
论气虚肿满 气虚肿满者，因脾气停滞，脾经受湿，气不流行，致头面虚浮，四肢肿满
，腹肚膨胀如鼓。上喘气急者，可与茯苓散、五苓散、三和散、分气紫苏饮、木香分气丸、
俞山人降气汤、小降气汤、苏子降气汤、曹脾散、嘉禾散。喘甚者，可与润金散、款肺散。
大便秘者，与三和散。小便不通，五苓散。
论干湿香港脚 香港脚有数种，痛不可忍者谓之寒；烦闷发渴者谓之热；肿而重者谓之湿。
用随证治之，不可一概论也。湿肿者，可与黄 建中汤、小续命汤。风湿者，可与术附汤。
热而发渴者，可与紫雪。冲心闷者，可与三和散、麻仁丸、降气汤。抢腰痛者，可与大乌沉
汤。
论小肠气疾 小肠气、膀胱奔豚、疝气等疾，皆因肾气虚弱，膀胱久冷，风湿乘之，伤
于肾经，气滞不散，小腹刺痛，肾经偏吊，未可骤服补药，先用疏导发散，可与苏子降气汤
、五苓散、蟠葱散、盐煎散、川楝散、大沉香丸，茴香丸，仍炒茴香烧盐细嚼，热酒送下，
或五香散、正元散、荜澄茄散之类。小便不通者，与鸡舌香散或五苓散。如痛稍退，只用平
胃散送下茴香丸调理。
论症积气块 症积气块，皆因气虚，及寒气、热气、怒气、恚气、喜气、忧气、愁气内
结积聚，坚牢如杯，心腹绞痛，不能饮食。用药渐渐消磨，不能宣利，可与七气汤、丁香丸
、青木香丸、木香推气丸、挨积丸、蓬煎丸。积气不散，腹胁膨胀，可与积气丸、三棱煎丸
。心下坚硬，结块冲心，可与温白丸。胀满不思食者，与养脾丸、消食丸、嘉禾散、四君子
汤。
论脾胃诸疾 久病脾泄，肠滑不禁，日久无度，虚羸者，可与平胃散，空心送下茴香汤
，兼服诃黎勒丸、丁香豆蔻散。服诸药不效者，可多与人参豆蔻散，有验。更有一种大便如
故，只是每日早晨水泻一、二行，日间都无事，可服金锁正元丹，泻止即住服。
论心脾疼证 妇人心脾疼，及血气刺痛者，可与蓬煎丸、拈痛丸。其拈痛丸性热，不可
轻用，如得见沉寒痼冷端的，方可用之。蟠葱散、鸡舌香散、盐煎散、如意丸皆可选用。若
痛连腰背，或小肠气刺痛，及虚弱老人，宜大沉香丸，两丸作一服立效，丈夫热酒下，妇人
醋汤下，如不吃酒，姜汤下。更可与和气散，调和脾胃。
论脾痛呕逆 脾胃痛甚，呕逆不纳食者，或加喘急者，可与七气汤。加吐者，与人参藿
香汤。泻者，与大沉香丸、人参豆蔻散、建中汤。忽暴心痛者，与苏合香丸、撞气沉香丸。
论心脾腹痛 心脾腹痛多有积。或有寒积者，可与温白丸或保安丸。虚、老人不可多服
此二药，只与木香推气丸或感应丸、小独圣丸、理痛丸，洗消去积，次与正气散、嘉禾散、
曹脾散、人参煮散、荜澄茄散、蟠葱散、盐煎散、鸡舌香散、挝脾散、建中散。有寒者，与
大沉香丸，两丸作一服，次与蓬煎丸、温中良姜丸、丁香煮散、四柱散。
论胸膈不快 胸膈不快，气滞者，可与沉香降气汤、乌沉汤、青木香丸、七气汤、和气
散，或人参丸、红丸子、小理中丸、撞气沉香丸、丁沉丸、顺气丸、三棱散、如意丸、蓬煎
丸。若烦闷甚，大便秘者，与青木香丸。脾痛者，可与蓬煎丸之类。
论脾虚翻胃 脾虚翻胃，不纳食及汤药不下者，可与膈气散、人参木香散、参苓白术散
、五膈宽中散。噫气吞酸，脾痛者，可与如意丸、思食丸之类。
论宿患心腹痛 有积块、气块、症癖日久，发歇不常者，不可取转，宜渐次消磨，可与
感应丸、温白丸、挨积丸、蓬煎丸、小理中丸少吃数丸，常服渐渐消磨，更与和脾散、嘉禾
散、参苓白术散、四君子汤、思食丸、健脾汤、建中散、平胃散之类，助其脾胃，久而能去
其根。若痛有休止，或往来上下，胸中 闷，时吐冷沫，中脘不快，呕逆恶心者，恐是虫痛
，可与集效丸或九痛丸。其九痛丸有利性，不可多服。若卒然心腹暴痛，膨急不得息，往来
攻冲，闷绝恶心者，恐是疰忤鬼气，可与苏合香丸。若虚弱脏寒人，可将苏合香丸捏作饼子
，用火熨斗盖之，将药饼安熨斗上爆，令药极热，以去其脑子性，依法服之。若痛而不休，
胸膈塞闷，呕吐不定，粥药不下者，可与顺气散送下青木香丸，如无顺气散，五积散送下亦
得，及九痛丸、三棱散、大沉香丸。
论腹胀心膨 腹胀者，若因伤寒，或寒热瘴疟，或泻痢大病之后，只是吃食后便腹胀心
膨，不美饮食，噫醋吞酸，纵食些小，亦觉膨胀者，切不可用消食克化之药，若用药动下，
转加困重，去生便远也。但可与正气散、嘉禾散、参苓白术散、四君子汤、曹脾散、人参煮
散、大、小养脾丸、荜澄茄散、思食丸、蓬煎丸、如意丸。泻者，与人参豆蔻散、丁香散。
但得气壮，自能饮食加倍，膨胀自愈。
(Attached: Spleen and Stomach Accumulations)
Discussion on All Qi Syndromes: All qi syndromes arise from emotional disturbances such as sorrow, grief, or extreme anger, which injure the True Qi (Zhen Qi), leading to disharmony of Yin and Yang. Qi knots in the chest and diaphragm, causing stagnation and discomfort, difficulty in swallowing food, eventually resulting in Ge-Ye disease (dysphagia). Formulas such as Yunqi San (Uniform Qi Powder), Wuge Kuanzhong San (Five Diaphragms Widening Middle Powder), Geqi San (Diaphragm Qi Powder), Chenxiang Jiangqi Tang (Aucklandia Descending Qi Decoction), Fenqi Zisu Yin (Separating Qi Perilla Infusion), Qi Qi Tang (Seven Qi Decoction), Jiahe San (Harmonious Grain Powder), Dingxiang Zhusan (Clove Boiled Powder), Fenxin Qi Yin (Separating Heart Qi Infusion), Xiao Jiangqi Tang (Small Descending Qi Decoction) may be used.
Discussion on Qi Deficiency Swelling and Fullness: Swelling and fullness due to Qi deficiency stem from stagnation of Spleen Qi and dampness invading the Spleen Meridian, causing impaired Qi circulation. This results in puffy swelling of the head and face, swollen and full limbs, and a drum-like distension of the abdomen. If accompanied by upward panting and rapid breathing, formulas such as Fuling San (Poria Powder), Wuling San (Five-Ingredient Poria Powder), Sanhe San (Three-Harmonies Powder), Fenqi Zisu Yin, Muxiang Fenqi Wan (Costus Separating Qi Pill), Yushanren Jiangqi Tang (Scholar Yushan's Descending Qi Decoction), Xiao Jiangqi Tang, Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction), Caopi San (Spleen-Causing Powder), and Jiahe San may be used. For severe panting, Runjin San (Moisten Metal Powder) and Kuansfei San (Soften Lung Powder) are suitable. For constipation, use Sanhe San. For urinary obstruction, use Wuling San.
Discussion on Dry and Damp Hongxiangjiao (Jamaica Foot/Charley Horse): Hongxiangjiao (foot strike disease) has several types. Severe pain that is unbearable is termed Cold; irritability, stuffiness, and thirst are termed Heat; swelling with heaviness is termed Damp. Treatment must follow the specific syndrome and cannot be generalized uniformly. For damp swelling, Huangqi Jianzhong Tang (Astragalus Middle-Building Decoction) and Xiao Xuming Tang (Small Continuation of Life Decoction) may be used. For wind-damp, Baizhu Fuzi Tang (Atractylodes and Aconite Decoction) is indicated. For heat with thirst, Zixue (Purple Snow) may be administered. For邪气 rushing to the heart causing stuffiness, Sanhe San, Maren Wan (Hemp Seed Pill), or Jiangqi Tang may be used. For pain attacking the waist, Da Wuchen Tang (Great Black Immortals Decoction) is appropriate.
Discussion on Small Intestine Qi Disorders: Disorders such as Small Intestine Qi, Bladder Ben Tun (Rushing Pig), and Hernia all result from Kidney Qi deficiency and long-standing cold in the Bladder, allowing Wind-Damp to invade and damage the Kidney Meridian. Qi stagnates and fails to disperse, causing stabbing pain in the lower abdomen and pulling pain along the Kidney Meridian. Tonifying medicines should not be administered hastily at this stage; instead, dredging and dispersing methods should be used first. Suitable formulas include Suzi Jiangqi Tang, Wuling San, Pancong San (Coil-Garlic Powder), Yanjian San (Salt-Fried Powder), Chuanlian San (Toosendan Fruit Powder), Dachencheng Wan (Great Ambergris Pill), Huixiang Wan (Fennel Pill). Alternatively, stir-fried fennel seeds mixed with roasted salt can be chewed finely and taken with hot wine, or Wuxiang San (Five-Aromatics Powder), Zhengyuan San (Upright Origin Powder), Bichengqie San (Cube Spice Powder) may be used. For urinary obstruction, Jishe Xiang San (Clove Leaf Powder) or Wuling San is indicated. Once pain subsides slightly, only Pingwei San (Stomach-Calming Powder) sent down with Huixiang Wan should be used for regulation.
Discussion on Zhengji (Masses) and Qi Lumps: Zhengji and Qi lumps arise from Qi deficiency combined with internal knotting and accumulation of Cold Qi, Heat Qi, Anger Qi, Resentment Qi, Joy Qi, Sorrow Qi, and Worry Qi. They become hard and firm like a cup, causing stabbing pain in the heart and abdomen and inability to eat. Medicines should gradually dissolve them. If unblocking and purgative methods fail, Qi Qi Tang, Dingxiang Wan (Clove Pill), Qingmuxiang Wan (Blue Costus Pill), Muxiang Tuiqi Wan (Costus Pushing Away Qi Pill), Aiji Wan (Remove Accumulation Pill), Pengjian Wan (Pengroot Fried Pill) may be used. If accumulated Qi does not disperse and causes abdominal and hypochondriac distension, Jiqi Wan (Accumulated Qi Pill) or Sanleng Jian Wan (Curcuma Fried Pill) may be used. For hardness below the heart with masses rushing to the heart, Wenbai Wan (Warm White Pill) is suitable. For distension and loss of appetite, Yangpi Wan (Nourish Spleen Pill), Xiaoshi Wan (Digest Food Pill), Jiahe San, and Sijunzi Tang (Four Gentlemen Decoction) are appropriate.
Discussion on Various Spleen and Stomach Diseases: For chronic Spleen diarrhea with intestinal sliding and uncontrollable evacuation, lasting for years with emaciation, Pingwei San may be used, taken on an empty stomach with Huixiang Tang (Fennel Decoction), combined with Helile Wan (Myrobalan Pill) and Dingxiang Doukou San (Clove and Cardamom Powder). If various medicines prove ineffective, Ren Shen Doukou San (Ginseng and Cardamom Powder) can be used in larger amounts, showing verified efficacy. In another type where stool remains normal but morning watery diarrhea occurs one or two times daily with no other issues during the day, Jin Suo Zhengyuan Dan (Golden Lock Upright Origin Elixir) may be taken until diarrhea stops, then discontinued.
Discussion on Heart and Spleen Pain Syndromes: For women suffering from Heart-Spleen pain and stabbing Blood-Qi pain, Pengjian Wan and Niantong Wan (Relieve Pain Pill) may be used. Note that Niantong Wan is hot in nature and should not be used lightly; it is only applicable when definite signs of deep-seated cold and chronic cold patterns are present. Pancong San, Jishe Xiang San, Yanjian San, and Ruyi Wan (As-You-Wish Pill) are also selectable options. If pain radiates to the back and waist, or involves stabbing pain from Small Intestine Qi, or affects weak elderly patients, Da Chencheng Wan is recommended. Two pills taken as one dose bring immediate relief. Men take with hot wine, women with vinegar decoction; if alcohol is not consumed, Ginger Decoction is used. Additionally, Heqi San (Harmonizing Qi Powder) can be used to harmonize the Spleen and Stomach.
Discussion on Spleen Pain and Vomiting/Reversal: For severe Spleen-Stomach pain with vomiting, reversal of Qi, and inability to retain food, or accompanied by panting, Qi Qi Tang may be used. If vomiting is prominent, Ren Shen Huoxiang Tang (Ginseng and Patchouli Decoction) is indicated. For diarrhea, Da Chencheng Wan, Ren Shen Doukou San, or Jianzhong Tang (Middle-Building Decoction) may be used. For sudden onset of Heart pain, Suhexiang Wan (Styrax Pill) or Zhuangqi Chencheng Wan (Strike Qi Ambergris Pill) are suitable.
Discussion on Heart and Spleen Abdominal Pain: Heart and Spleen abdominal pain often involves accumulations. For Cold accumulations, Wenbai Wan or Bao'an Wan (Security and Peace Pill) may be used. These two medicines should not be taken in large quantities by deficient patients or the elderly. Instead, Muxiang Tuiqi Wan, Yinggan Wan (Responsive Action Pill), Xiao Dusheng Wan (Small Unique Holy Pill), or Litong Wan (Regulate Pain Pill) should be used to wash away and dissolve accumulations, followed by Zhengqi San (Upright Qi Powder), Jiahe San, Caopi San, Ren Shen Zhusan (Ginseng Boiled Powder), Bichengqie San, Pancong San, Yanjian San, Jishe Xiang San, Zhuapi San (Claw Spleen Powder), and Jianzhong San. For those with Cold, Da Chencheng Wan (two pills as one dose) is given, followed by Pengjian Wan, Wenzhong Liangjiang Wan (Warm Middle Galangal Pill), Dingxiang Zhusan, and Sizhu San (Four Pillars Powder).
Discussion on Chest and Diaphragm Discomfort: For chest and diaphragm discomfort due to Qi stagnation, Chenxiang Jiangqi Tang, Wuchen Tang (Black Immortals Decoction), Qingmuxiang Wan, Qi Qi Tang, Heqi San, or Renshen Wan (Ginseng Pill), Hongwanzi (Red Pellet), Xiaolizhong Wan (Small Regulate Middle Pill), Zhuangqi Chencheng Wan, Dingchen Wan (Clove and Ambergris Pill), Shunqi Wan (Smooth Qi Pill), Sanleng San, Ruyi Wan, Pengjian Wan may be used. If irritability is severe and constipation exists, Qingmuxiang Wan is indicated. For Spleen pain, Pengjian Wan and similar formulas are suitable.
Discussion on Spleen Deficiency Fanwei (Inverted Stomach): For Fanwei caused by Spleen deficiency, where food and liquids cannot be retained, Geqi San, Ren Shen Muxiang San (Ginseng and Costus Powder), Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), and Wuge Kuanzhong San may be used. For belching and acid regurgitation with Spleen pain, Ruyi Wan or Sixi Wan (Desire-to-Eat Pill) may be used.
Discussion on Chronic Heart and Abdominal Pain: For long-standing masses, Qi lumps, or Zhengpi (masses and parasites) with irregular attacks, forceful expulsion should be avoided; gradual dissolution is preferred. Yinggan Wan, Wenbai Wan, Aiji Wan, Pengjian Wan, and Xiaolizhong Wan may be taken in small doses frequently to gradually dissolve the condition. Additionally, Hepar San (Harmonize Spleen Powder), Jiahe San, Shenling Baizhu San, Sijunzi Tang, Sixi Wan, Jianpi Tang (Strengthen Spleen Decoction), Jianzhong San, and Pingwei San should be used to support the Spleen and Stomach, thereby eliminating the root cause over time. If pain has intervals, moves up and down, causes chest stuffiness, frequent spitting of cold saliva, and epigastric discomfort with nausea, it may be Worm Pain. Ji Xiao Wan (Collect Effect Pill) or Jiutong Wan (Nine-Pain Pill) may be used. Note that Jiutong Wan has purgative properties and should not be overdosed. For sudden violent Heart and Abdominal pain, urgent distension preventing breathing, wandering attacking pain, fainting, and nausea, it may be Zhu Wu Gui Qi (Infectious Evil Ghost Qi). Suhexiang Wan is indicated. For weak individuals with internal Cold organs, Suhexiang Wan can be shaped into cakes, placed on a hot iron soleplate covered by the plate, heated until extremely hot to remove its "brain" (camphor/musk) cold nature, and then taken according to method. If pain persists, chest blockage, indeterminate vomiting, and inability to take porridge or medicine occur, Shunqi San sent down with Qingmuxiang Wan may be used. If Shunqi San is unavailable, Wuji San (Five Accumulations Powder) sent down with Jiutong Wan, Sanleng San, or Da Chencheng Wan is acceptable.
Discussion on Abdominal Distension and Heart Swelling: For abdominal distension following Shanghan (Cold Damage), Cold-Heat Malaria, or severe dysentery/diarrhea, where eating immediately triggers abdominal distension and Heart swelling, poor appetite, belching with acid regurgitation, and even slight intake causing bloating, digestive and resolving medicines must strictly be avoided. Using such drugs to induce defecation will worsen fatigue and distance recovery. Instead, Zhengqi San, Jiahe San, Shenling Baizhu San, Sijunzi Tang, Caopi San, Ren Shen Zhusan, Da/Xiao Yangpi Wan (Large/Small Nourish Spleen Pills), Bichengqie San, Sixi Wan, Pengjian Wan, and Ruyi Wan may be used. For diarrhea, Ren Shen Doukou San or Dingxiang San (Clove Powder) is indicated. As long as Qi becomes strong, appetite will naturally double, and distension will heal itself.